At the times I became pregnant with my three children, my psoriasis wasn't at its worst. I had spots here and there, though it definitely wasn't widespread (that would come later). Looking back, I realize how fortunate I was to have mild psoriasis at these times, meaning I didn't have to stop or switch a medication. But I do recall asking my doctor whether the topical I often applied - Dovonex - and my special shampoos and scalp treatments would be safe to use (they were). And with my third child, I did face a particular trying time nursing since a guttate psoriasis flare covered my entire body, even my chest.
When you're trying to have a baby, are in the midst of pregnancy, or you're nursing, everything from what and when you eat to how you exercise is a big consideration. If you have psoriasis, whether it's mild or severe in nature, your treatment plan likely will need to change some, if not quite a bit. Of course you'll want to talk with both your obstetrician and dermatologist to determine what's best for you and your baby, but consider these general guidelines for managing your psoriasis if you're trying to conceive, you're expecting or you're a nursing mom.
Stopping altogether may be recommended. Some doctors suggest avoiding any kind of psoriasis treatments, or at the very least using only the safest forms. This would include certain topical treatments and UVB phototherapy. Another option: natural remedies, such as herbs, vitamins and other supplements that may be safe to use pre-pregnancy, throughout pregnancy and while nursing. I've tried these with little success, though I've known other psoriasis patients who have done well, particularly before, during and after pregnancy. You'll want talk through any option you choose with your health care provider.
You may have to modify your plan. While I ended up using the topical Dovonex throughout my pregnancies, I was forced to limit its use following the birth of my third child because psoriasis covered my breasts (and the rest of my body) for several long months. It would have been messy and I worried about my son ingesting any of the medication, even though I was careful. It's important to note that some topical drugs when used over widespread body surfaces will be absorbed through the skin and into the mother's milk. Experts say systemic medications should be avoided when nursing because of the possibility of passing the drugs' active ingredients onto the infant.
For many women with psoriasis, their disease remains unchanged throughout pregnancy. Some, however, may endure worsening of symptoms. Still others may see their condition improve. The latter is what I experienced, to an extent; some of my most stubborn spots suddenly disappeared during those nine months. Research has shown that hormonal changes associated with pregnancy improve overall skin condition, including the symptoms of psoriasis.
How about you - how has psoriasis played a role in your psoriasis management? What has worked, and what hasn't?